Liang Shuo, Zhu Lan, Song Xiaochen, Xu Tao, Sun Zhijing, Lang Jinghe
1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China 2Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, PR China.
Menopause. 2016 Jul;23(7):765-70. doi: 10.1097/GME.0000000000000628.
The aim of the study was to evaluate the anatomical and functional outcomes of modified laparoscopic sacrocolpopexy (MLSC) for the treatment of advanced pelvic organ prolapse (POP).
From May 2009 to September 2012, a consecutive prospective observational study of 30 participants was conducted to evaluate MLSC as a treatment for symptomatic advanced POP at Peking Union Medical College Hospital. The Pelvic Organ Prolapse Quantification (POP-Q) classification was used to determine the POP stage. Validated tools were used to evaluate symptoms (Pelvic Floor Distress Inventory, PFDI-20) and sexual function (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, PISQ-12). Measurements were recorded preoperatively and then at 3 months and yearly after surgery. We compared the follow-up results with the preoperative data.
All participants completed a 3-year clinical follow-up routine. The anatomical results at 3 months showed significant improvements (P < 0.05) compared with the preoperative results based on the POP-Q measurements. This improvement remained significant after 3 years (P < 0.05). The anatomical cure rate was 100% and 96.7% at 3 months and 3 years after surgery, respectively. Pelvic floor function remained significantly improved after surgery compared with preceding surgery (P < 0.05) according to the following measures: PFDI-20 (106.2 vs 36.0), Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6, 47.9 vs 13.7), Colorectal-Anal Distress Inventory-8 (CRADI-8, 29.2 vs 9.2), and Urinary Distress Inventory-6 (UDI-6, 29.2 vs 13.2). The participants maintained a high level of sexual function (PISQ-12: 29.0 vs 35.1, P < 0.05). One case of mesh exposure (3.3%) and two cases of de novo dyspareunia (8.7%) were observed.
MLSC seems to be a safe and effective procedure that achieves good long-term anatomical and functional results.
本研究旨在评估改良腹腔镜骶骨阴道固定术（MLSC）治疗重度盆腔器官脱垂（POP）的解剖学和功能学效果。
2009年5月至2012年9月，在北京协和医院对30名参与者进行了一项连续的前瞻性观察研究，以评估MLSC治疗有症状的重度POP的效果。采用盆腔器官脱垂定量（POP-Q）分类法确定POP分期。使用经过验证的工具评估症状（盆底困扰量表，PFDI-20）和性功能（盆腔器官脱垂/尿失禁性功能问卷，PISQ-12）。术前及术后3个月和每年记录测量数据。我们将随访结果与术前数据进行了比较。
所有参与者均完成了为期3年的临床随访常规检查。基于POP-Q测量，术后3个月的解剖学结果与术前结果相比有显著改善（P<0.05）。3年后这种改善仍然显著（P<0.05）。术后3个月和3年时，解剖学治愈率分别为100%和96.7%。根据以下指标，与前次手术相比，术后盆底功能仍有显著改善（P<0.05）：PFDI-20（106.2对36.0）、盆腔器官脱垂困扰量表-6（POPDI-6，47.9对13.7）、结直肠-肛门困扰量表-8（CRADI-8，29.2对9.2）和尿路困扰量表-6（UDI-6，29.2对13.2）。参与者维持了较高的性功能水平（PISQ-12：29.0对35.1，P<0.05）。观察到1例网片暴露（3.3%）和2例新发性交困难（8.7%）。
MLSC似乎是一种安全有效的手术方法，能取得良好的长期解剖学和功能学效果。
